چکیده (انگلیسی):

Background: Using finger-stick capillary blood to assess lactate from the microcirculation may have
utility in treating critically ill patients. Our goals were to determine how finger-stick capillary lactate
correlates with arterial lactate levels in patients from the surgical intensive care unit, and to compare
how capillary and arterial lactate trend over time in patients undergoing resuscitation for shock.
Methods: Capillary whole blood specimens were obtained from finger-sticks using a lancet, and assessed
for lactate via a handheld point-of-care device as part of an “investigational use only” study. Comparison
was made to arterial blood specimens that were assessed for lactate by standard laboratory reference
methods.
Results: 40 patients (mean age 68, mean APACHEII 18, vasopressor use 62%) were included. The correlation
between capillary and arterial lactate levels was 0.94 (p < 0.001). Capillary lactate measured
slightly higher on average than paired arterial values, with a mean difference 0.99 mmol/L. In patients
being resuscitated for septic and hemorrhagic shock, capillary and arterial lactate trended closely over
time: rising, peaking, and falling in tandem. Clearance of capillary and arterial lactate mirrored clinical
improvement, normalizing in all patients except two that expired.
Conclusion: Finger-stick capillary lactate both correlates and trends closely with arterial lactate in critically
ill surgical patients, undergoing resuscitation for shock.